Medicare, Medicaid and Medigap Questions

1. Why do I have to have Part A Medicare when I already have private insurance?

   Since you receive SSDi, you are required to be covered by Medicare Part A. You are also covered by your spouse's employer plan. These coverages work together without duplication. Depending on how many employees there are in your spouse's company, Medicare will either be primary or secondary. If there are less than 100 employees, it will be primary...
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2. How do I find a psychiatrist in the Medicare pages?

   To find a psychiatrist on the Medicare site, go to http://www.medicare.gov/find-a-doctor/(X(1)S(vrwfryzkpm5rbhn4cfhl3g55))/provider-search.aspx
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3. If not completely satisfied with VA, will Medicare Part B provide full coverage?

   If you are covered by the VA's medical program and also are enrolled in Medicare Part B, you have a choice about which program will cover any particular medical service or treatment. However, you cannot use both programs for the save service or treatment. that's because they work in completely separate ways...
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4. Will Medicare cover pre-existing conditions?

   The good news is that Medicare does not have any preexisting conditions. As soon as you are enrolled in the program, you are covered for any past or present medical conditions. So if you can wait until you are enrolled, Medicare will pay for your surgery. Keep in mind that Medicare does have deductibles and copays...
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5. FAQ: Can Medicaid Coverage Be Retroactive?

   Yes, Medicaid (called Medi-Cal in California) medical, home care, and nursing home coverage can be retroactive. If someone is approved for Medicaid, coverage can go back not only to the date of application but also to three months prior to the application. But retroactive coverage is not automatic...
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6. FAQ: What Are Medicare Part A and Medicare Part B Premiums, Deductibles, and Coinsurance Amounts for 2011?

   Medicare premiums, deductibles, and coinsurance amounts change each year for Medicare Part A and Medicare Part B. (For people who receive their Medicare hospital and medical coverage through a Medicare Part C Medicare Advantage plan, premiums, deductibles, and co-payments are determined by the plan itself, not by Medicare...
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7. Does Medicare pay for shingles vaccine?

   No, it won't. In general, Medicare doesn't do a very good job of covering preventive medical care . The only immunizations it covers are a yearly flu shot, the pneumonia vaccine, and the vaccine against hepatitis B (if you are at medium or high risk for contracting the disease).
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8. What is the allowable amount for prescription eyeglasses under Medicare?

   Medicare coverage for eyeglasses is handled through Medicare Part B. Medicare can pay for one pair of eyeglasses following your cataract surgery, if you had a new lens implanted in your eye. If you have two separate cataract operations, one on each eye, Medicare will cover new glasses after each surgery...
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9. What are our options after Medicare benefits are exhausted?

   It sounds like you and the social worker had a misunderstanding. Certain specific Medicare Part A inpatient hospital benefits may run out temporarily, and one part of Medicare Part A's long-term hospital coverage may end, but overall Medicare coverage does not become exhausted...
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10. Does Medicare cover driving evaulations?

    Medicare Part B could cover a "driving evaluation" at an outpatient rehabilitation facility if it's prescribed by a doctor. Medicare Part B covers some rehabilitation services following an injury, illness or other change in a patient's condition. These services can be physical therapy, occupational therapy, or both...
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11. How can I find assistance for a procedure not covered by Medicare?

    It sounds from your question that the podiatrist is including Medicare in this statement about insurance. If so, you have to find out WHY your podiatrist believes that neither Medicare nor other insurance will cover the treatment. Extracorporeal shock wave is certainly an approved treatment for several medical conditions, including some bone spurs...
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12. Will Medicare cover a non-routine lab test ordered by my doctor?

    Whether Medicare covers a laboratory test doesn't depend on whether it's "routine" -- in fact, Medicare doesn't cover many routine lab tests -- but whether it's "medically necessary." Having the test ordered by your doctor is the first part of this process of deciding whether it's medically necessary...
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13. How do we switch from private to Medicare?

    If she had both Medicare and health insurance coverage through a large employer while she was still working, the employer-based insurance (in this case, Anthem Blue Access) paid first, with Medicare paying some of the remaining costs. Since she is no longer working, Medicare will become the primary payer, which means that medical bills go first to Medicare...
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14. If I work full-time should I enroll in Medicare?

    Whether it's to your advantage to enroll in Medicare Part B medical insurance or in a Medicare Part D prescription drug plan while you're still working full-time depends on the extent, cost, and rules of the health insurance coverage provided through your employment...
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15. Can Medicare prevent me from hiring a companion for a resident in a nursing home?

    Medicare is not likely to know or care if you hire a private companion to sit with your relative while he or she is in a skilled nursing facility. However, the nursing facility itself might not permit it. Medicare nursing home coverage is provided only in a skilled nursing facility and only for a patient...
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16. If our private insurance doesn't cover a claim, can we send it to Medicare?

    You've asked several different questions about Medicare, so let's take them one at a time. First, you can submit your husband's medical bills to Medicare even if you've also submitted them to your work-related insurance. Which coverage pays first depends on the size of your employer...
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17. Does Medicare pay for patient ceiling lifts?

    Medicare Part B covers medical equipment that includes "patient lifts" -- mechanical or hydraulic devices that help to safely lift a person out of or into a bed or chair. These lifts are intended to avoid injuries to patients and caregivers alike...
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18. Does Medicare pay for electric wheelchair replacement batteries?

    Today's Option is a private Medicare Part C Medicare Advantage plan that you have enrolled in and that provides all your Medicare coverage, including coverage for your wheelchair. In order to find out the specifics of how the plan will cover replacement batteries for your wheelchair, you need to carefully...
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19. Will Medicare accept property as payment or collateral?

    You are in a situation a lot of people find themselves in – trying to help someone stay at home rather than have to enter a nursing facility or other long-term residence, but unable to provide enough round-the-clock care. Unfortunately, Medicare’s home care coverage is extremely l...
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20. How do I know if there are better Medicare options out there for me?

    Even if you are relatively satisfied with the Medicare Part C Medicare Advantage plan that you now have, at the end of each year (between November 15 and December 31) you may want to consider switching to a better plan -- or to traditional Medicare plus a Medigap supplemental insurance policy -- for the coming year...
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